286
Diseases Study Group for
Legionella
Infections (ESGLI) for more precise
information on distribution and relatedness than is achievable with only
serological subtyping (67). Since there is no direct correlation betweenMAb
patterns and STs, both methods provide helpful but disparate information
when used to characterize
L. pneumophila
from environmental or clinical
sources.
Conclusion
Legionnaires’ disease is a consequence of altering the environment
for human benefit. It is likely that humans and
Legionella
have co-existed
for a very long time but recent industrial technology has provided these
bacteria a means for causing infection in humans. Legionnaires’ disease is
the most common etiologic agent of waterborne disease in drinking water
in the United States where the incidence of disease has more than doubled
in the past decade (27). Although the disease can be effectively treated
with appropriate antimicrobial agents, measures aimed at preventing
transmission of the bacteria from environmental sources to susceptible
hosts are varied and of questionable efficacy. Health care professionals,
engineers, and industry associations continue to increase their awareness
and understanding of legionellae and legionellosis. However, it can be
difficult to determine whether increased understanding has led to measures
that have reduced the incidence of this disease. Empirical antibiotic
treatment of pneumonias within four hours of admission, while providing
better outcomes for the patient, inhibits public health surveillance on the
incidence of legionellosis. Effective strategies can only be measured by
approaches that both understand the incidence of disease and measure the
efficacy of preventative actions. Although
Legionella
cannot be eradicated
